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Treatment of Experimental Fungal Keratitis

Treatment of Experimental Fungal Keratitis Abstract Several excellent reviews10,11,26,39,42 and case reports4,5,21,24,27 have emphasized the difficulty in treatment of mycotic keratitis and the aggravating effects of some antibiotics20,33,41 and steroids1,4,20,28,40 on these infections. The various forms of chemotherapy have included amphotericin B with debridement,4,5,13 30% sodium sulfacetamide solution by iontophoresis,13 1:1,000 Merthiolate ophthalmic ointment,13 nystatin topically,9,31 local cycloheximide,23 and oral sodium iodide with local 0.125% copper sulfate and tincture of iodine.2,6 Poor intraocular penetration29 and local toxicity1 of the suggested drugs have hampered interpretation of chemotherapy. Physical measures suggested for treatment have included ultraviolet phototherapy,7 thermophore,2 and excision with keratoplasty.42 Human clinical experience has been difficult to evaluate because the stage of the disease at the time of treatment has varied and the fungus has differed from case to case. The number of cases reported by any single study has been References 1. altimore Biological Laboratory. 2. The Shahan Thermophore is calibrated in Fahrenheit, ie, 71.1 C±6 C equivalent to 160 F±1 F. 3. These include 29 rabbits in experiment 2 in which corneas of left eyes were traumatized with a trephine. 4. Agarwal, L.P., et al: Mycotic Corneal Ulcers , Brit J Ophthal 47:109, 1963.Crossref 5. Allen, J.H., in discussion of Haggerty, T.E., and Zimmerman, L.E.: Mycotic Keratitis , Southern Med J 51:153, 1958.Crossref 6. Alvis, E.B., and Shahan, P.: Personal communication to the author. 7. Anderson, B., Jr., and Chick, E.W.: Mycokeratitis: Treatment of Fungal Corneal Ulcers With Amphotericin B and Mechanical Debridement , Southern Med J 56:270, 1963.Crossref 8. Barsky, D.: Keratomycosis: A Report of Six Cases : Arch Ophthal 61:547, 1959.Crossref 9. Byers, J.L.; Holland, M.G.; and Allen, J. H.: Cephalosporium Keratitis , Amer J Ophthal 49:267, 1960. 10. Chick, E.W.; Hudnell, A.B.; and Sharp, D.G.: Ultraviolet Sensitivity of Fungi Associated With Mycotic Keratitis and Other Mycoses , Sabouraudia , 2 ( (pt 4) ):193, 1963. 11. Currie, D.: Mycotic Keratitis , Arch Ophthal 70:335, 1963.Crossref 12. von Dieckhues, B.; Küper, J.; and Fegeler, F.: Zur Therapie der Keratomykose , Klin Mbl Augenheilk 141:912, 1962. 13. Editorial: Keratomycosis , Brit Med J 5331:629, 1963. 14. Fazakas, S.: Summarizing Report on Mycotic Superinfection in Diseases of the Lid Borders, Conjunctiva, and Cornea , Ophthalmologica 138:108, 1959.Crossref 15. Foster, J.B.T., et al: Some Intraocular and Conjunctival Effects of Amphotericin B in Man and in the Rabbit , Arch Ophthal 60:555, 1958.Crossref 16. Gingrich, W.P.: Keratomycosis , JAMA 179:602, 1962.Crossref 17. von Graf, K.: Über einen fall von keratomycosis der menschlichen hornhaut, hervorgerufen durch Candida albicans , Klin Mbl Augenh 142:578, 1963. 18. Grocott, R.G.: A Stain for Fungi in Tissue Sections and Smears Using Gomori's Methenamine Silver Nitrate Technique , Amer J Clin Path 25:975, 1955. 19. Haggerty, T.E., and Zimmerman, L.E.: Mycotic Keratitis , Southern Med J 51:153, 1958.Crossref 20. Kobayashi, G.S., and Friedman, L.: Characterization of the Pyrogenicity of Candida albicans, Saccharomyces cerevisiae, and Cryptococcus neoformans , J Bact 88:660, 1964. 21. Kobayashi, G.S.; Friedman, L., and Koforth, J.F.: Some Cytological and Pathogenetic Properties of Spheroplasts of Candida albicans , J Bact 88:795, 1964. 22. Kuhn, L.R.: Effect of Elevated Body Temperature on Cryptococcus in Mice , Proc Soc Exp Biol Med 71:341, 1949.Crossref 23. Ley, A.P.: Experimental Fungus Infections of the Cornea: A Preliminary Report , Amer J Ophthal 42:59 (Oct, (pt 2) ), 1956. 24. Ley, A.P., and Sanders, T.E.: Fungus Keratitis: A Report of Three Cases , Arch Ophthal 56:257, 1956.Crossref 25. Litwin, M.L., and Zimmerman, L.E.: Cryptococcosis; Torulosis or European Blastomycosis , New York: Grune and Stratton, 1956, pp 125-128. 26. Lynn, J.R.: Fusarium Keratitis Treated With Cycloheximide , Amer J Ophthal 58:637, 1964. 27. Manchester, P.T., Jr., and Georg, L.K.: Corneal Ulcer due to Candida parapsilosis (C. parakrusei) , JAMA 171:163, 1959. 28. Manual of Histologic and Special Staining Technique , Armed Forces Institute of Pathology, Washington, DC, 1960. 29. McLean, J.M.: Oculomycosis , Amer J Ophthal 56:537, 1963. 30. Mendelblatt, D.L.: Moniliasis. A Review and a Report of the First Case Demonstrating Candida albicans in the Cornea , Amer J Ophthal 36:379, 1953. 31. Mitsui, Y., and Hanabusa, J.: Corneal Infections After Cortisone Therapy , Brit J Ophthal 39:244, 1955.Crossref 32. Montana, J.A., and Sery, T.W.: Effect of Fungistatic Agents on Corneal Infections With Candida albicans , Arch Ophthal 60:1, 1958.Crossref 33. Post, L.: Thermophore Therapy and Experimental Studies , Trans Amer Ophthal Soc 22:353, 1924. 34. Roberts, S. S.: Nystatin in Monilia Keratoconjunctivitis , Amer J Ophthal 44:108, 1957. 35. Schwartz, B., and Feller, M.R.: Temperature Gradients in the Rabbit Eye , Invest Ophthal 1:513, 1962. 36. Seligmann, E.: Virulence Enhancement of Candida albicans by Antibiotics and Cortisone , Proc Soc Exp Biol Med 83:778, 1953.Crossref 37. Shahan, W.E.: Effects of Heat on the Eye , JAMA 68:1969, 1917.Crossref 38. Shahan, W.E.: Further Studies of the Effects of Heat on the Eye , JAMA 68:1969, 1917.Crossref 39. Shahan, W.E.: Selective Thermotherapy , Amer J Ophthal 6:978, 1923. 40. Shahan, W.E.: Thermal Death Points . Contributions to Ophthalmic Science , Menasha, Wis, p 87, 1926. 41. Shahan, W.E.: Accuracy Factors in Selective Thermotherapy , Trans Amer Ophthal Soc 37:289, 1939. 42. Suie, T., and Havener, W.H.: Mycology of the Eye: A Review , Amer J Ophthal 56:64, 1963. 43. Thygeson, P.; Hogan, M.J.; and Kimura, S.J.: Cortisone and Hydrocortisone in Ocular Infections , Trans Amer Acad Ophthal Otolaryng 157:64, 1953. 44. Van Winkle, M.G.; Rheins, M.S.; and Suie, T.: Effects of Antibiotics on Experimental Candida Corneal Infections , Amer J Ophthal 57:84, 1964. 45. Zimmerman, L.E.: Keratomycosis , Survey Ophthal 8:1, 1963. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1965.00970040405022
Publisher site
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Abstract

Abstract Several excellent reviews10,11,26,39,42 and case reports4,5,21,24,27 have emphasized the difficulty in treatment of mycotic keratitis and the aggravating effects of some antibiotics20,33,41 and steroids1,4,20,28,40 on these infections. The various forms of chemotherapy have included amphotericin B with debridement,4,5,13 30% sodium sulfacetamide solution by iontophoresis,13 1:1,000 Merthiolate ophthalmic ointment,13 nystatin topically,9,31 local cycloheximide,23 and oral sodium iodide with local 0.125% copper sulfate and tincture of iodine.2,6 Poor intraocular penetration29 and local toxicity1 of the suggested drugs have hampered interpretation of chemotherapy. Physical measures suggested for treatment have included ultraviolet phototherapy,7 thermophore,2 and excision with keratoplasty.42 Human clinical experience has been difficult to evaluate because the stage of the disease at the time of treatment has varied and the fungus has differed from case to case. The number of cases reported by any single study has been References 1. altimore Biological Laboratory. 2. The Shahan Thermophore is calibrated in Fahrenheit, ie, 71.1 C±6 C equivalent to 160 F±1 F. 3. These include 29 rabbits in experiment 2 in which corneas of left eyes were traumatized with a trephine. 4. Agarwal, L.P., et al: Mycotic Corneal Ulcers , Brit J Ophthal 47:109, 1963.Crossref 5. Allen, J.H., in discussion of Haggerty, T.E., and Zimmerman, L.E.: Mycotic Keratitis , Southern Med J 51:153, 1958.Crossref 6. Alvis, E.B., and Shahan, P.: Personal communication to the author. 7. Anderson, B., Jr., and Chick, E.W.: Mycokeratitis: Treatment of Fungal Corneal Ulcers With Amphotericin B and Mechanical Debridement , Southern Med J 56:270, 1963.Crossref 8. Barsky, D.: Keratomycosis: A Report of Six Cases : Arch Ophthal 61:547, 1959.Crossref 9. Byers, J.L.; Holland, M.G.; and Allen, J. H.: Cephalosporium Keratitis , Amer J Ophthal 49:267, 1960. 10. Chick, E.W.; Hudnell, A.B.; and Sharp, D.G.: Ultraviolet Sensitivity of Fungi Associated With Mycotic Keratitis and Other Mycoses , Sabouraudia , 2 ( (pt 4) ):193, 1963. 11. Currie, D.: Mycotic Keratitis , Arch Ophthal 70:335, 1963.Crossref 12. von Dieckhues, B.; Küper, J.; and Fegeler, F.: Zur Therapie der Keratomykose , Klin Mbl Augenheilk 141:912, 1962. 13. Editorial: Keratomycosis , Brit Med J 5331:629, 1963. 14. Fazakas, S.: Summarizing Report on Mycotic Superinfection in Diseases of the Lid Borders, Conjunctiva, and Cornea , Ophthalmologica 138:108, 1959.Crossref 15. Foster, J.B.T., et al: Some Intraocular and Conjunctival Effects of Amphotericin B in Man and in the Rabbit , Arch Ophthal 60:555, 1958.Crossref 16. Gingrich, W.P.: Keratomycosis , JAMA 179:602, 1962.Crossref 17. von Graf, K.: Über einen fall von keratomycosis der menschlichen hornhaut, hervorgerufen durch Candida albicans , Klin Mbl Augenh 142:578, 1963. 18. Grocott, R.G.: A Stain for Fungi in Tissue Sections and Smears Using Gomori's Methenamine Silver Nitrate Technique , Amer J Clin Path 25:975, 1955. 19. Haggerty, T.E., and Zimmerman, L.E.: Mycotic Keratitis , Southern Med J 51:153, 1958.Crossref 20. Kobayashi, G.S., and Friedman, L.: Characterization of the Pyrogenicity of Candida albicans, Saccharomyces cerevisiae, and Cryptococcus neoformans , J Bact 88:660, 1964. 21. Kobayashi, G.S.; Friedman, L., and Koforth, J.F.: Some Cytological and Pathogenetic Properties of Spheroplasts of Candida albicans , J Bact 88:795, 1964. 22. Kuhn, L.R.: Effect of Elevated Body Temperature on Cryptococcus in Mice , Proc Soc Exp Biol Med 71:341, 1949.Crossref 23. Ley, A.P.: Experimental Fungus Infections of the Cornea: A Preliminary Report , Amer J Ophthal 42:59 (Oct, (pt 2) ), 1956. 24. Ley, A.P., and Sanders, T.E.: Fungus Keratitis: A Report of Three Cases , Arch Ophthal 56:257, 1956.Crossref 25. Litwin, M.L., and Zimmerman, L.E.: Cryptococcosis; Torulosis or European Blastomycosis , New York: Grune and Stratton, 1956, pp 125-128. 26. Lynn, J.R.: Fusarium Keratitis Treated With Cycloheximide , Amer J Ophthal 58:637, 1964. 27. Manchester, P.T., Jr., and Georg, L.K.: Corneal Ulcer due to Candida parapsilosis (C. parakrusei) , JAMA 171:163, 1959. 28. Manual of Histologic and Special Staining Technique , Armed Forces Institute of Pathology, Washington, DC, 1960. 29. McLean, J.M.: Oculomycosis , Amer J Ophthal 56:537, 1963. 30. Mendelblatt, D.L.: Moniliasis. A Review and a Report of the First Case Demonstrating Candida albicans in the Cornea , Amer J Ophthal 36:379, 1953. 31. Mitsui, Y., and Hanabusa, J.: Corneal Infections After Cortisone Therapy , Brit J Ophthal 39:244, 1955.Crossref 32. Montana, J.A., and Sery, T.W.: Effect of Fungistatic Agents on Corneal Infections With Candida albicans , Arch Ophthal 60:1, 1958.Crossref 33. Post, L.: Thermophore Therapy and Experimental Studies , Trans Amer Ophthal Soc 22:353, 1924. 34. Roberts, S. S.: Nystatin in Monilia Keratoconjunctivitis , Amer J Ophthal 44:108, 1957. 35. Schwartz, B., and Feller, M.R.: Temperature Gradients in the Rabbit Eye , Invest Ophthal 1:513, 1962. 36. Seligmann, E.: Virulence Enhancement of Candida albicans by Antibiotics and Cortisone , Proc Soc Exp Biol Med 83:778, 1953.Crossref 37. Shahan, W.E.: Effects of Heat on the Eye , JAMA 68:1969, 1917.Crossref 38. Shahan, W.E.: Further Studies of the Effects of Heat on the Eye , JAMA 68:1969, 1917.Crossref 39. Shahan, W.E.: Selective Thermotherapy , Amer J Ophthal 6:978, 1923. 40. Shahan, W.E.: Thermal Death Points . Contributions to Ophthalmic Science , Menasha, Wis, p 87, 1926. 41. Shahan, W.E.: Accuracy Factors in Selective Thermotherapy , Trans Amer Ophthal Soc 37:289, 1939. 42. Suie, T., and Havener, W.H.: Mycology of the Eye: A Review , Amer J Ophthal 56:64, 1963. 43. Thygeson, P.; Hogan, M.J.; and Kimura, S.J.: Cortisone and Hydrocortisone in Ocular Infections , Trans Amer Acad Ophthal Otolaryng 157:64, 1953. 44. Van Winkle, M.G.; Rheins, M.S.; and Suie, T.: Effects of Antibiotics on Experimental Candida Corneal Infections , Amer J Ophthal 57:84, 1964. 45. Zimmerman, L.E.: Keratomycosis , Survey Ophthal 8:1, 1963.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Sep 1, 1965

References